<div id="badSourceDetail">
    <div class="main" style="background-color: #e5e5e5;">
        <h4>填写申请人基本信息</h4><!-- bgColor121222-->
		<div class="form_component minus_margin radius">
	        <label class="border">执业证号</label>
	        <div class="ipt_area">
	            <input class="white_border placeholder_text_999999" type="tel" placeholder="请填写律师执业证号" ng-model='practiceNo'>
	        </div>
	        <div class="star">*</div>
	    </div>
        <div class="form_component minus_margin radius">
	        <label class="border">申请人</label>
	        <div class="ipt_area">
	            <input class="white_border placeholder_text_999999" type="tel" placeholder="请填写申请人名称" ng-model='applyUserName'>
	        </div>
	        <div class="star">*</div>
	    </div>
	    <div class="form_component minus_margin radius">
	        <label class="border">律所名称</label>
	        <div class="ipt_area">
	            <input class="white_border placeholder_text_999999" type="text" placeholder="请填写律所名称" ng-model='lawyerAreaName'>
	        </div>
	        <div class="star">*</div>
	    </div>
	    <div class="form_component minus_margin radius">
	        <label class="border">联系手机号</label>
	        <div class="ipt_area">
	            <input class="white_border placeholder_text_999999" type="tel" placeholder="请填写申请人联系方式" maxlength='11' ng-model='telNo'>
	        </div>
	        <div class="star">*</div>
	    </div>
	    <div class="sbt_bt_component" ng-click="goNext()">
	        <div>下一步</div>
	    </div>
	</div>
</div>